> There was a helicopter and an ambulance there when we arrived. There were 2
> serious head and chest injuries.
> The helicopter crew wanted to transfer the more seriously injured patient,
> because it would only be 9 mins flying time. The patient's airway was
> compromised so I had to do a RSI at the roadside. I ordered the crew to
take
> the other patient who was maintaining his airway, but still needed rapid
> attention. Does anyone else have this problem with helicopters? Speed is
not
> everything!
As with all time critical pre-hospital scenes when the pressure is on, there
is considerable room for differing interpretation of the clinical situation
and opinion on what is necessary in which timeframe.
I am aware of this event and certainly the view of the helicopter paramedics
who were on scene. I have not had the opportunity to discuss the events
directly with Ray and do not feel that an open discussion group is the place
for this sort of analysis or "post-mortem".
I accept that there were two very difficult calls to make regarding the
timing and location of airway control, with two very different levels of both
pre-hospital experience and airway experience. We are in constructive
discussion with the intensivists within our Region about pre-hospital
chemical airway control to help with just this sort of problem.
While not questioning his clinical assessment, it concerned me slightly that
Ray "ordered" the paramedics, to whom he was an unknown clinician, to change
the already decided triage priorities. The potential for conflict and bad
feeling here is huge and has been the subject of discussion in this forum
before.
Best wishes
Darren Walter
Medical Advisor
Yorkshire Air Ambulance
|